We design and conduct streamlined trials which assess the efficacy and safety of treatments reliably in order to inform and change clinical practice and influence future research. Our trials are known internationally for their large size and efficiency, and have had a major impact on the treatment and prevention of cardiovascular disease.
We develop hypotheses about causal risk factors for cardiovascular and other diseases, then look for treatments that can produce sustained and substantial changes in those risk factors. These hypotheses are often informed by our large observational studies. For example, studies suggested that lower HDL cholesterol is associated with higher risk of cardiovascular disease, so our THRIVE and REVEAL trials tested drugs that raise HDL cholesterol. Vascular meta-analyses also inform our studies (e.g. the HPS and SHARP trials of LDL cholesterol lowering resulted from the Cholesterol Treatment Trialists' [CTT] Collaboration, and the ASCEND trial of aspirin in low-risk people with diabetes resulted from our work in the Antithrombotic Trialists' [ATT] Collaboration).
We have developed computing and laboratory methods that facilitate streamlined trial design, and a key objective of the cross-cutting theme of Big Data and computing innovation is to reduce unnecessary barriers to conducting trials. For example, we are developing novel ways of accessing routine healthcare data in support of trials, and we are campaigning for revision of the regulatory requirements for clinical trials, including the Good Clinical Practice (GCP) guidelines, through the Good Clinical Trials Collaborative.
MRC PHRU researchers are leading the RECOVERY trial of potential COVID-19 treatments, in collaboration with colleagues from other parts of the Nuffield Department of Population Health, and from the Nuffield Department of Medicine. The trial delivered the first major breakthrough in COVID-19 treatment, the finding that dexamethasone improves the likelihood of survival for severely ill patients.